Readers respond to articles on smoking and pain relief.

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I commend Leon Neyfakh and the Globe Magazine on an enlightening report on cigarette smoking and other tobacco and nicotine use on college campuses (“Blown Away,” December 8). According to the US surgeon general, the number of smokers who initiated smoking after age 18 increased from 600,000 in 2002 to 1 million in 2010. As director of the Tobacco-Free College Campus Initiative, a collaboration of the US Department of Health and Human Services, the University of Michigan, and the American College Health Association, I am pleased to share that in the 14 months since our launch, we have seen an astonishing 45 percent increase in the number of campuses with comprehensive smoke-free policies. More campuses are including electronic cigarettes in their policies. Little is known about the health effects of e-cigarettes, and experts fear that they can impede smokers’ cessation efforts, complicate compliance and enforcement efforts, and re-normalize the act of smoking.

Clifford E. Douglas

University of Michigan

School of Public Health

On October 25, Tobacco Free Mass set a goal of tripling the number of campuses in Massachusetts with a smoke- and tobacco-free policy from 12 to 36 by 2015. Given that 25 percent of 18-to-22-year-old full-time college students report that they smoke and that nearly 99 percent of current smokers started before the age of 26, we must reinforce and support the social norm Neyfakh described so well. This January marks the 50th anniversary of the first surgeon general’s report on the harmful effects of smoking, and there is no better way to honor that milestone than to ensure that our nation’s students are educated in tobacco- and smoke-free environments.

I started smoking because it was cool. Fast-forward 25 years. I finally quit. Now I am 70 years old and do not take breathing lightly. I have been hospitalized with chronic obstructive pulmonary disease and congestive heart failure. I spent a year with an oxygen tank as my constant companion. You cannot appreciate how wonderful it is to be able to take a breath unless you have been breathless.

nancyka

posted at bostonglobe.com

SUFFERERS SPEAK UP

Thank you for Judy Foreman’s article about chronic pain (Perspective, December 8). Because of a health condition and surgery that went wrong when I was 7 years old, I’ll suffer from chronic pain for the rest of my life. My doctor has prescribed Tylenol with codeine to manage the pain. Then my pharmacy decided to play games with my prescription. It claimed that it didn’t receive it from my doctor and that my insurance company had denied it. When I called the insurance company, I was told that’s not true. Finally, the prescription was filled after I was humiliated and made to feel vilified, as if I were doing something wrong or, worse yet, illegal. I realize that opioid addiction is a horrible thing, but please don’t judge those of us with a legitimate need.

Patricia McGregor

Beverly

I was born with spina bifida occulta and have been taking narcotics for many years and have never once abused them. I go to Florida for the winter, and from the way I am treated, you would think I was a junkie. I have been humiliated and embarrassed at the pharmacy when I hand in my prescription. This article is the first positive one I have read since all this business has been going on.

Judi Driscoll

Walpole

While regulators are well intentioned, we share Foreman’s concerns about swinging the pendulum back toward undertreatment of pain. At Boston University School of Medicine, we have been working for more than three years to educate clinicians in safe and competent opioid prescribing through our SCOPE of Pain training (scopeofpain.com). After training some 20,000 clinicians nationally, we find that they are eager to change their prescribing practices to be consistent with practice guidelines. Clinician education is an important first step.